Ultrasound-assisted catheter placement in CT-guided HDR brachytherapy for the local ablation of abdominal malignancies: Initial experience

Abstract

Purpose To evaluate the safety and feasibility of sonographically-assisted catheter placement in interstitial high-dose-rate brachytherapy of abdominal malignancies.

Materials and Methods In an initial cohort of 12 patients and 16 abdominal tumors (colorectal liver metastases n = 9; renal cell cancer n = 3; hepatocellular carcinoma n = 2; cholangiocellular carcinoma n = 2), initial puncture and catheter placement for CT-guided brachytherapy were performed under sonographic assistance when possible. The interventional procedure was prospectively recorded and in-patient data were collected. All data underwent descriptive statistics and comparative analysis by the Mann-Whitney test.

Results In 12 out of 16 lesions (diameter 1.5 – 12.9 cm), initial puncture was successfully achieved under ultrasound guidance without utilization of CT fluoroscopy, yielding a significantly shorter mean total fluoroscopy time (14.5 vs. 105.5 s; p = 0.006). In 8 lesions visibility was rated better in ultrasound than in CT fluoroscopy (p = 0.2). No major or minor complications occurred within 30 days after treatment.

Conclusion Ultrasound-assisted catheter placement during interstitial CT-guided brachytherapy of abdominal tumors could improve catheter positioning and reduce radiation exposure for medical staff.

Key points Ultrasound-assisted catheter placement in CT-guided brachytherapy is safe and feasible. Ultrasound puncture may improve catheter positioning. Reduced CT fluoroscopy time can significantly help to minimize radiation exposure for medical staff.

Citation Format

• Damm R, El-Sanosy S, Omari J et al. Ultrasound-assisted catheter placement in CT-guided HDR brachytherapy for the local ablation of abdominal malignancies: Initial experience. Fortschr Röntgenstr 2019; 191: 48 – 53

Key words

brachytherapy - interventional procedures - ultrasound computed tomography (US/CT)

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